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Journal of Mind and Medical Sciences is published by MDPI from Volume 12 Issue 1 (2025). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Valparaiso University (ValpoScholar).
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Review

The Burden of Clostridium Difficile Infection in Patients with Liver Cirrhosis

by
Despina Moraru
1,
Andrada Dumitru
1,
Sergiu Ioan Micu
1,*,
Marilena Musat
1,
Gabriel Preda
1 and
Popoiag Roxana Emanuela
2
1
Department of Gastroenterology, St. Apostle Andrew Emergency Hospital, Constanta, Romania
2
Department of Internal Medicine - Gastroenterology, The Faculty of Medicine, Ovidius University, Constanta, Romania
3
Department of Diabetes Mellitus and Nutritional Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
*
Author to whom correspondence should be addressed.
J. Mind Med. Sci. 2019, 6(2), 237-242; https://doi.org/10.22543/7674.62.P237242
Submission received: 14 March 2019 / Revised: 16 July 2019 / Accepted: 16 July 2019 / Published: 9 October 2019

Highlights

  • Patients with liver cirrhosis are characterized by alterations of inherited and acquired immunosuppression, being an easy target for Clostridium Difficile, which is associated with significant morbidity and mortality.
  • The latest guideline treatment recommendations for an initial episode of Clostridium Difficile have changed, either vancomycin or fidaxomicin now currently chosen over metronidazole.

Abstract

Clostridium Difficile Infection (CDI) has registered a dramatically increasing incidence in the general population over the past decades. Nowadays, Clostridium Difficile is the leading cause of hospital-acquired diarrhea in Europe and North America. Liver cirrhosis is the final stage of any chronic liver disease (CLD). The most common causes are chronic hepatitis C or B and viral co-infections, alcohol misuse, and nonalcoholic fatty liver disease (NAFLD). CLD and cirrhosis are listed among the ten leading causes of death in the US. Cirrhosis due to any etiology disrupts the homeostatic role of the liver in the body. Cirrhosis-associated immune dysfunction (CAID) leads to alterations in both inherited and acquired systemic and local liver immunity. CAID is caused by increased systemic inflammation and immunodeficiency and it is responsible for 30% of mortality rates all over the world. Clostridium Difficile infection frequently affects patients suffering from liver cirrhosis because of the high number of prolonged hospitalizations, regular use of antibiotics for the prevention or treatment of SBP, proton pump inhibitor (PPI) use, and an overall immunocompromised state. Clostridium Difficile is a Gram-positive bacterium responsible for the high morbidity and mortality rates in patients with cirrhosis, with an essential increase in a 30-day mortality.
Keywords: clostridium difficile; liver cirrhosis; anaerobic infection; immune dysfunction clostridium difficile; liver cirrhosis; anaerobic infection; immune dysfunction

Share and Cite

MDPI and ACS Style

Moraru, D.; Dumitru, A.; Micu, S.I.; Musat, M.; Preda, G.; Emanuela, P.R. The Burden of Clostridium Difficile Infection in Patients with Liver Cirrhosis. J. Mind Med. Sci. 2019, 6, 237-242. https://doi.org/10.22543/7674.62.P237242

AMA Style

Moraru D, Dumitru A, Micu SI, Musat M, Preda G, Emanuela PR. The Burden of Clostridium Difficile Infection in Patients with Liver Cirrhosis. Journal of Mind and Medical Sciences. 2019; 6(2):237-242. https://doi.org/10.22543/7674.62.P237242

Chicago/Turabian Style

Moraru, Despina, Andrada Dumitru, Sergiu Ioan Micu, Marilena Musat, Gabriel Preda, and Popoiag Roxana Emanuela. 2019. "The Burden of Clostridium Difficile Infection in Patients with Liver Cirrhosis" Journal of Mind and Medical Sciences 6, no. 2: 237-242. https://doi.org/10.22543/7674.62.P237242

APA Style

Moraru, D., Dumitru, A., Micu, S. I., Musat, M., Preda, G., & Emanuela, P. R. (2019). The Burden of Clostridium Difficile Infection in Patients with Liver Cirrhosis. Journal of Mind and Medical Sciences, 6(2), 237-242. https://doi.org/10.22543/7674.62.P237242

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